Vented Patient PEA

[whitecat5000]

So this might sound like a stupid question but . . .

how do you know your patient went into a PEA if he's on a vent?

We were told in school that one of the only ways to tell if they're having a PEA is if they stop breathing. . .

Maybe I'm just not thinking clearly about it?

[bjaeram]

PEA, as others have noted, is characterized by a lack of pulse. Of course, they won't be breathing either. Note that EKG monitoring will not always tell you if you have PEA, which can look like a perfectly nice normal sinus rhythm.

That's pretty funny. If you can find a way to administer antibiotics from the doorway and deliver meal trays with your mind, let me know. :)

You aren't in the room 24/7. I often peek in without actually going in. Plus just because you go in doesn't mean you check a pulse.

I've never seen a person on a vent need a meal tray!

[mcleanl]

This is a good question. I actually had a vascular pt, several years ago that occluded his graft and needed to go to the OR stat. He was intubated, SR on the monitor. We packed him up to go the OR, placed him on the portable monitor/vent and started out the door when I happened to notice that his rhythm looked slightly different......it was PEA. Our monitor didn't pick it up and the pt didn't have an A-line. He potentially could have made it to the OR without any of us noticing!

[wooh, BSN, RN]

You aren't in the room 24/7. I often peek in without actually going in. Plus just because you go in doesn't mean you check a pulse.

I check on each and every one of my patients at least every 15 minutes by throwing on the lights in the room and doing a full head to toe assessment to make sure NOTHING has changed since the previous assessment 15 minutes before.

I've never seen a person on a vent need a meal tray!

Hehe!

[defyinggravity2009]

I check on each and every one of my patients at least every 15 minutes by throwing on the lights in the room and doing a full head to toe assessment to make sure NOTHING has changed since the previous assessment 15 minutes before.

Hehe!

Is your employer hiring? I wish my job had that kind of time and staffing!

[EMSnut45, BSN, RN, EMT-P]

A quick and easy way to tell if your heart rhythm has perfusion (if you don't have an arterial line as someone else suggested) is to look at the heart rate on the pulse ox. If they don't correlate, you have a problem.

I had an intubated pt on dialysis a while back. The dialysis nurse came out of the room all frantic saying that she couldn't get a blood pressure reading. Then I noticed that the pulse ox heart rate was not correlating with the rhythm rate. Yup... you bet... CODE!!!

More recently, I went into a room to help another nurse with her pt. She was upset because her pt was tachy according to the rhythm rate, but had a cruddy blood pressure all night. Of course the resident was trying to sleep, and was only ordering fluid boluses. The heart rhythm was kinda funky with very frequent PVC's and PAC's, and I noticed that the pulse ox rate was not correlating-- it was infact much slower-- like in the 30's. I felt for a radial pulse, and yes, the perfusing heart rate was in the 30's. We then paged the resident as the pt's problem was not dehydration, it was rate related.

[dudemursestudent]

check a pulse, or look at the wave form on the pulse ox or arterial line. Pulse is always front line assessment though

[anurseuk]

A vented patient would be in a room by themselves?

And throughing the lights on every 15 minutes? Poor patients!

[LaughingRN]

Poor Wooh

I think your sarcasm is woefully wandering in a dark alley....lost

I found it though,

Sincerely,

Laughing

[ebear, BSN, RN]

I found it too, wooh!